- No biologically measurable response has been found – these are people with normal celiac serology (neg ttg/ema) and normal biopsies.
- Specific discussions regarding autism and schizophrenia. On page 44, authors note that a 2008 Cochrane review concluded the evidence for a gluten-free diet for autism was poor. In 2012, a two-stage RCT (Whiteley et al) of gluten-free casein-free diet reported significant group improvements after 8 and 12 months on diet. Thus, diet may be helpful.
- Other chapters allude to NCGS as well. Page 124: “There are no epidemiologic studies assessing the prevalence of NCGS. Bizzaro et al estimated that for every one person with CD, there are at least six to seven with gluten sensitivity.”
- Forms include oral food allergy, “wheat-dependent, exercise-induced anaphylaxis,” and Baker’s asthma (aerosolized exposure).
- Skin prick tests or RAST’s are notorious for providing a high rate of false-positive results. Low rate of false negative results, though, are noted.
Treatment -Section VI:
- This section provides a number of tables to assist with diet and hidden sources of gluten.
- GFD may lead to specific nutrient deficiencies: fiber, iron, folate, niacin, zinc, vitamins B12, A, D, E, and K; also, GFD may be higher in fat.
Psychological Aspects -Section VII:
- Labs to check in sick CD patient (Table 2 -page 133).
- Causes of Nonresponse to GFD: poor compliance, accidental ingestions, nonceliac disease causing symptoms.
- While some of the authors state that true refractory disease is “rare in adults,extremely rare in children,” in other parts of the book it is noted that complete histologic response is not seen in all patients (some with apparently good adherence).
IgA deficiency (page 139).
- 85-90% of IgA deficient patients have no clinical symptoms. Occurs in about 1 in 300. For those with symptoms, manifestations could include sinopulmonary disease, allergy/atopy, autoimmune diseases, giardiasis/infections, and transfusion reactions (against IgA) (see Table 8 on page 143).
- Transiently low IgA is common in children <4 years.
- For IgA deficient patients, risk of CD is 10-20 times general population.
- In true deficiency, level is typically <7 mg/dL. More often, there is a partial deficiency which is ‘almost always asymptomatic.’ In partial IgA deficiency, IgA assays identify about 90% of CD cases.
- An Unexpected Twist for “Gluten Sensitivity” | gutsandgrowth
- What to make of FODMAPs | gutsandgrowth
- UVA Links | gutsandgrowth this entry has links to specific nutritional advice for several diets.
- Gluten sensitivity without celiac disease | gutsandgrowth
- Today’s AJC –celiac disease and gluten sensitivity | gutsandgrowth
- Food choices, FODMAPs, and gluten haters | gutsandgrowth